What are the responsibilities and job description for the Insurance Benefits Specialist position at McEwen & Associates, Inc?
JOB SUMMARY :
The Insurance Benefits Specialist provides patients and physician offices with insurance benefit information. This position ensures timely verification of insurance benefits and financial clearance which has a direct impact to the organization's reimbursement from payers for patient accounts that are scheduled and unscheduled.
SHIFT AND SCHEDULE :
Full Time : Monday to Friday 8 : 00 am to 5 : 00 pm.
ESSENTIAL FUNCTIONS :
- Performs financial clearance of patient accounts by verifying insurance eligibility and benefits and ensuring all notifications and authorizations are completed within the required timeframe.
- Completes appropriate payor forms related to notification and authorization.
- Coordinates the submission of clinical documentation from physicians to payers for authorization needs.
- Calculates accurate patient financial responsibility.
- Communicates timely with Utilization Review, and partners effectively with physician and facility staff to ensure financial clearance of the patient's account prior to scheduled or unscheduled service
- Interprets complex payer coverage information including, but not limited to, network participation status with provider, limited plan coverage and inactive benefits.
- Assists co-workers and clients with complex questions and issues.
- Documents systems according to the Insurance Verification guidelines to assure accurate and timely reimbursement.
- Manages workflow of specific area to ensure maximum results for department as requested.
KEY SUCCESS FACTORS :
REQUIREMENTS :
About McEwen & Associates, Inc :
McEwen and Associates, Inc. is a medical services organization based in Irving, TX. We are committed to providing physicians and allied healthcare professionals with personalized and efficient service.
Salary : $18 - $20